Eleonora Teplinsky, MD

Eleonora Teplinsky, MD Breast and gynecologic medical oncologist in NJ focusing on patient education and cancer advocacy.

12/14/2025

Sharing some research on GLP-1 medications (weight loss/ anti obesity medications) and breast cancer from the San Antonio Breast Cancer Symposium. We are beginning to see some early signals that they may help with chemotherapy side effects and may have beneficial effects on breast cancer outcomes but it’s still very early data. More in the video!

12/12/2025

New study presented at SABCS on menopausal hormone therapy (MHT) in women with BRCA1 and BRCA2 mutations who had no history of breast cancer and no prior bilateral mastectomy at the time they enrolled (some later went on to have bilateral mastectomy but most did not). All participants entered menopause either naturally or after surgery, most commonly after removal of the ovaries.

Researchers compared 676 women who used MHT and 676 women who did not use MHT. Average age was ~44. In the MHT group, women were followed for about 6 and a half years. ~81% were BRCA1 carriers, and about 19% were BRCA2. On average, women used MHT for nearly six years.

Women who used MHT had fewer breast cancers than women who did not. There were 87 breast cancer cases in the MHT group compared with 128 cases in the non-MHT group. This decrease in incidence was driven by the use of estrogen alone MHT but estrogen plus progesterone did not increase breast cancer risk.

Most women used transdermal estradiol. While the numbers for other estrogen formulations were small, all showed a similar trend toward reduced risk. There was no estrogen formulation that increased risk. The reduction reached statistical significance with transdermal estradiol, but that may reflect larger numbers rather than a true difference between formulations. There was no significant association based on the type of progestogen used. This is reassuring for women who require progesterone because they still have a uterus.

A small subgroup of women used Duavee (estrogen + bazedoxifene, which works as an anti-estrogen in breast and uterus). Among the 43 women who used Duavee (most BRCA1) none developed breast cancer during follow-up.

Bottom Line: MHT did not increase breast cancer risk in BRCA carriers. Estrogen-only therapy was associated with a lower risk and estrogen plus progesterone did not increase risk.

Some subgroups were small, tumor receptor status wasn’t analyzed, and longer follow-up is needed. Need more info on role of hysterectomy, role of Duavee and the big question of MHT after a BC diagnosis.

Let me know your questions!

12/11/2025

In this video, I discuss ribociclib and abemaciclib in early stage HR+/HER2- breast cancer. Both are CDK 4/6 inhibitors which interfere with the cell cycle and are used in combination with endocrine therapy to decrease the risk of recurrence.

Ribociclib: 400 mg daily 21 days on/7 days off for 3 years
At 5 years: absolute improvement in invasive disease free survival (survival without disease) was 4.5% in patients receiving ribociclib (81% in endocrine therapy alone versus 85.5% in ribociclib+endocrine therapy).
Common side effects: low blood 🩸 counts, liver enzyme elevations, headache, nausea 🤮 and fatigue. Have to monitor EKG 🫀at the beginning of treatment (before starting and at 2 weeks).

Abemaciclib: 150 mg twice daily for 2 years.
Invasive disease free survival was improved by 6.5% at the 7 year follow up mark with the addition of abemaciclib. 18% of patients on abemaciclib developed a recurrence event versus 24.5% in the endocrine therapy alone arm.
Common side effects: diarrhea 💩, low blood counts, fatigue, headache 🤕 and decreased appetite.

Let me know your questions or experiences w CDK 4/6 inhibitors in early stage breast cancer.

12/10/2025

Let’s talk about lidERA trial which was presented at SABCS! This study tested whether the oral SERD (selective estrogen receptor degrader), giredestrant, is superior to current endocrine therapy as adjuvant therapy in ER+/HER2 negative early stage breast cancer. Giredestrant binds to the estrogen receptor and induces a change in it that not only blocks the estrogen receptor but breaks it down as well. SERDs are approved in metastatic breast cancer but this is the first study in early stage breast cancer.

Over 4,000 patients with stage I-III breast cancer were randomized to receive giredestrant (daily oral medication) or endocrine therapy with tamoxifen or an aromatase inhibitor. 84% of patients in ET arm received AI. If premenopausal, patients had to receive ovarian suppression with giredestrant and with an aromatase inhibitor (did not have to with tamoxifen but many did). 90% of patients had stage 2-3 breast cancer. 10% had stage 1. If lymph node negative, patients also had to have tumors >1cm with grade 3, Ki67>=20% or high risk scores on genomic assay (MammaPrint or Oncotype) or T4 disease.

RESULTS:
Giredestrant reduced risk of invasive disease recurrence or death (invasive disease free survival) by 30%. Patients were followed for about 32 months on average: 89.6% were alive without recurrence with AI or tamoxifen compared to 92.4% with giredestrant (absolute benefit of about 3%). There were very few recurrences in stage 1 disease. There was a relative 31% reduction in risk of metastatic disease with giredestrant.

Most common side effects with giredestrant were joint pain, hot flashes, headaches, fatigue, insomnia, and nausea and were similar compared to those side effects in tamoxifen or aromatase inhibitors. However, 1.8% of patients discontinued giredestrant due to musculoskeletal 🦴 symptoms like joint pain compared to 4.4% of patients with endocrine therapy.

‼️ Not yet FDA approved. This study was not done with CDK 4/6 inhibitors so we don’t know how this would affect (? further increase) benefit.
💰may be a factor as well! Oral SERDs are very expensive in metastatic disease!

Let me know all your questions!!

12/09/2025

Started off SABCS with a session on breast cancer risk and alcohol 🍷 use. I go into this in the video but I want to stress that this is NOT to cause blame or shame for anyone. Alcohol is just one of many cancer risk factors but we also know that many Americans are not aware or unsure about alcohol and cancer risk so it is an important discussion to have. You are NOT to blame for a cancer diagnosis.

In this video, I discuss 5 key points on alcohol: amount and risk, type of alcohol and risk, impact of binge drinking (4+ drinks for women at one time), how your body prioritizes metabolizing alcohol since it views as a toxin and limited data on alcohol after a breast cancer diagnosis and impact on recurrence. Let me know your thoughts or questions on this topic!

12/09/2025

I’m heading to Texas in the morning for the San Antonio Breast Canver Symposium! So many exciting studies being presented and I’ll share as much as I can but here are 5 that I’m really excited about (and this is just scratching the surface!):

1. Giredestrant vs standard-of-care endocrine therapy as adjuvant treatment for patients with estrogen receptor-positive, HER2-negative early breast cancer: Results from the global Phase III lidERA Breast Cancer trial

2. Her2climb-05: a randomized, double-blind, phase 3 study of tucatinib versus placebo in combination with trastuzumab and pertuzumab as maintenance therapy for her2+ metastatic breast cancer

3. Adjuvant aromatase inhibitor or tamoxifen in patients with hormone receptor-positive/HER2-positive early breast cancer: An exploratory analysis from the ALTTO (BIG 2-06) trial

4. Menopausal Hormone Therapy and the Risk of Breast Cancer in Women with a Pathogenic Variant in BRCA1 or BRCA2

5. Risk-based breast cancer screening is safe, preferred by women and identifies highest risk individuals: Results from WISDOM 1.0

Let me know what you want to hear about! I’ll be sharing as much as I can!!

For my birthday this year, I decided to do something different: a private Pilates class followed by a cold plunge/sauna/...
12/07/2025

For my birthday this year, I decided to do something different: a private Pilates class followed by a cold plunge/sauna/red light therapy with some of the best women in my life at .nj! A fantastic way to start the year focusing on movement, mindfulness, balance and friendship 🩷

12/05/2025

Let’s talk about San Antonio Breast Cancer Symposium, scalp cooling and the shift toward insurance billing. At SABCS, I am excited to participate in an event with , moderated by the amazing . We are going to be talking about the shift toward insurance based billing, why that’s important, and scalp cooling in general. If you are going to SABCS and want to attend this event, let me know!! I I would love to know your thoughts about scalp cooling, questions, how you made your decisions, and what you wish you had known before, during or after going through scalp cooling.  .

12/02/2025

Talking about AIMSS: Aromatase Inhibitor Musculoskeletal Syndrome: the constellation of muscular skeletal symptoms that are associated with aromatase inhibitor use, including joint and muscle pain, joint stiffness and tendon issues. It occurs in approximately 1/3 to 1/2 of women taking aromatase inhibitors but some believe that the incidence is higher.

A lot of the joint pain is due in large part to low estrogen, which increases inflammation, impacts cartilage, and alters pain perception. In this video, I talk about some options for treatment. I would love to hear your experiences and what has worked for you. Let me know.

11/29/2025

How are you taking care of yourself this holiday season? Let me know!

Wishing everyone a very Happy Thanksgiving and wonderful holiday season. Feeling very grateful today and sending you all...
11/27/2025

Wishing everyone a very Happy Thanksgiving and wonderful holiday season. Feeling very grateful today and sending you all love 🩷

11/24/2025

Let’s talk about non hormonal treatments for hot flashes including the newly approved FDA medication, elinzanetant (Lynkuet). BlinkRx is a mail order pharmacy that currently has Lynkuet for a $25 copay. I’ve started it prescribing it there for my patients. Let me know your experience with hot flashes and any questions you have!

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